More than 500 people have signed up for coordinated health care plan

Prue Salasky, psalasky@dailypress.com

More than 500 adults in Southeastern and Central Virginia who receive both Medicare and Medicaid, a group known as "dual eligibles," have already signed up for the state's new Commonwealth Coordinated Care program.

Voluntary enrollment started March 1. In May, automatic enrollment will kick in for those eligible unless they opt out.

Last week, Gov. Terry McAuliffe touted the rollout of the managed-care program as a key cost-saving reform for the state's Medicaid program. In Virginia, 78,000 people are eligible for Medicaid and Medicare and 36,000 live in Tidewater — the official designation of the region that includes Hampton Roads — and Central Virginia, the first two regions to start enrollment. Three other regions in the state will enter the three-year pilot program on a staggered schedule.

The program is designed to save the state money through providing care that's both better coordinated and more person-centered. Virginia is the third state, following Massachusetts and Illinois, to implement this type of program. The savings included in the state budget is more than $44 million, according to Craig Markva, spokesman for the Department of Medical Assistance Services, which oversees Medicaid in Virginia.

At the March meeting of SANG — the Senior Advocate Networking Group — held at Colonial Harbor in Yorktown on Wednesday, Sarah Broughton, DMAS community educator, explained the details of the program.

Three Medicare-Medicaid health plans — Humana, Anthem Healthkeepers and Virginia Premier — have contracted with the federal and state programs to provide services through the coordinated care program in Virginia. The Tidewater region includes Hampton Roads, the Eastern Shore and Northern Neck. The plans are still establishing networks of providers.

"It's still in flux," said Broughton, who noted that patients will have a six-month grace period to transition between providers if they're not included in their chosen plan.

Riverside has a letter of agreement with Anthem and "intends to be part of its network," according to Shannon Fedors, a health system spokeswoman. People are already signing up for coverage effective April 1, said Doug Bennett, Anthem spokesman. In May, automatic enrollment will take effect in the region, said Broughton. She emphasized that it's a voluntary program and that people can opt out at any time and go back to original Medicare — or switch plans — without penalty.

The coordinated care plans are required to provide individuals with a case manager who's charged with assembling an interdisciplinary care team to develop an overall health plan; they are also required to provide a local call center 24/7 with access to their health records. Some plans also offer additional services not covered by traditional Medicare, such as vision testing, glasses and hearing aids.

Eligible participants, who include those with the Elderly or Disabled with Consumer Direction waiver and residents of nursing facilities, will use a single ID card in place of their prescription card, Medicare card and Medicaid card.